Tuesday, March 9, 2010

Acne vulgaris

Acne vulgaris - Chronic


 


 

Definition  

A chronic disorder of the pilosebaceous unit affecting almost everyone at one time or another .


 

Medical History  

* Cleanser and Moisturizer use

* Cosmetic use

* Corticosteroid use

* Skin reaction irritant

* Increased androgen level

* Oral contraception


 

Findings  

* Acne keloid

* Acne nodule

* Closed comedone

* Ice-pick acne scar

* Open comedone

* Papular eruption

* Post-inflammatory hyperpigmentation

* Pustule


 

Differential Diagnosis  

* Rosacea

* Folliculitis

* Gram-negative folliculitis

* Plane wart

* Perioral dermatitis

* Milia

* Steroid acne

* Chlorine acne

* Pseudofolliculitis barbae

* Acne fulminans

* Hidradenitis suppurativa

* Miliaria

* Fibrous skin tumor of tuberous sclerosis

* Nodular elastosis with cysts AND comedones of Favre and Racouchot

* Acne cosmetica

* Acne mechanica

* Neonatal acne

* Acne conglobata

* Excoriated acne

* Pyoderma faciale


 

Treatment  


 

Drug Therapy  


 


 

Mild to moderate acne  


 

BENZOYL PEROXIDE  

Adults: Apply to affected area once or twice daily


 

TRETINOIN (Related toxicological information in TRETINOIN AND RELATED AGENTS)  

Adults: Apply to affected area once nightly


 

ADAPALENE  

Adults: Apply to affected area once daily


 

TAZAROTENE  

Adults: Apply to affected area once nightly


 

ERYTHROMYCIN  

Adults: 250-500 mg orally two to four times daily


 

CLINDAMYCIN HYDROCHLORIDE  

Adults: 150 mg orally once or twice daily


 

SALICYLIC ACID (Related toxicological information in SALICYLATES)  

Adults: Apply to affected area once or twice daily


 

AZELAIC ACID (Related toxicological information in AZELAIC ACID)  

Adults: Apply to affected area once or twice daily


 

SULFACETAMIDE SODIUM  

Adults: Apply to affected area once or twice daily


 

DOXYCYCLINE  

Adults: 50-100 mg orally once or twice daily


 

MINOCYCLINE HYDROCHLORIDE  

Adults: 50-100 mg orally once or twice daily


 

TETRACYCLINE  

Adults: 250-500 mg orally once or twice daily


 

SULFAMETHOXAZOLE/TRIMETHOPRIM  

Adults: 1 double-strength tab (trimethoprim 160 mg/sulfamethoxazole 800 mg) orally twice daily


 

ETHINYL ESTRADIOL/NORETHINDRONE ACETATE  


 


 

ETHINYL ESTRADIOL/NORGESTIMATE  


 


 

SPIRONOLACTONE  

Adults: 50-200 mg orally daily in divided doses


 


 

Nonpregnant patients with severe acne  


 

ISOTRETINOIN (Related toxicological information in ISOTRETINOIN)  

Adults: 0.5-1 mg/kg/day orally in divided doses


 


 

Acne vulgaris in patients 12 years and older  


 

CLINDAMYCIN PHOSPHATE/TRETINOIN  

Adults: At bedtime, place a pea-sized amount on one fingertip and dot onto chin, cheeks, nose, and forehead, then rub over the entire face

Pediatrics (?12 years): At bedtime, place a pea-sized amount on one fingertip and dot onto chin, cheeks, nose, and forehead, then rub over the entire face


 

Non-Procedural Therapy  


 

Acne vulgaris  

* Skin Care

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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence